Effect of Lifestyle and Symptom Intensity Factors on the Severity of Lower Limbs Veins of Varicose Among Nurses in North Khorasan Hospitals, Iran

Document Type : Original Article


1 Department of Medical Surgical Nursing, Faculty Member of Nursing and Midwifery School, Iran University of Medical Sciences, Tehran, Iran.

2 Department of Nursing, Faculty Member of Nursing and Midwifery School, Sabzevar University of Medical Sciences, Sabzevar, Iran.


Scarce data have been reported regarding the risk factors of lower limb varicose veins (VVs) in Iranian nurses. This study investigated the social and occupational parameters and lifestyle related to the development of VVs in a group of Iranian nurses.
Materials and Methods:
In the current cross-sectional study, 235 volunteered nurses filled the consent forms and were then examined by a vascular specialist. Varicose veins of the patient nurses were ranked based on Clinical, Etiological, Anatomical, and Pathophysiological criteria. Afterward, the patients completed the lifestyle questionnaire.
In this study, there were 163 (69.4%), 64 (27.2%), and 8 (3.4%) cases with mild, moderate, and severe VVs. It was revealed that VVs severity had a significant relationship with age, laboring times, abortion times, and body mass index (P<0.005). It was also found that weight control and nutrition (odds ratio [OR] =3.76) and physical activity (OR=4.038) significantly affected the VVs intensity.
This study highlighted lifestyle risk factors of VVs, which can be considered in improving the lifestyle and quality of life of nurses in long term.


  1. Beebe-Dimmer JL, Pfeifer JR, Engle JS, Schottenfeld D. The epidemiology of chronic venous insufficiency and varicose veins. Annals of epidemiology. 2005;15(3):175-84.
  2. Robertson L, Evans Ca, Fowkes F. Epidemiology of chronic venous disease. Phlebology. 2008;23(3):103-11.
  3. Bootun R, Onida S, Lane TR, Davies AH. Varicose veins and their management. Surgery (Oxford). 2016;34(4):165-71.
  4. Marsden G, Perry M, Kelley K, Davies AH. Diagnosis and management of varicose veins in the legs: summary of NICE guidance. Bmj. 2013; 347.
  5. Chen C-L, Guo H-R. Varicose veins in hairdressers and associated risk factors: a cross-sectional study. BMC Public Health.2014;14(1):1-6.
  6. Nasiri-Foourg A, Kazemi T, Nakhaii N, Kazemi N. Lower limb varicose veins and their relationship with risk factors in nurses of the Birjand University of Medical Sciences Hospital's. Journal of birjand university of medical sciences. 2005; 12(1):9-15.
  7. Tabatabaeifar S, Frost P, Andersen JH, Jensen LD, Thomsen JF, Svendsen SW. Varicose veins in the lower extremities in relation to occupational mechanical exposures: a longitudinal study. Occupational and environmental medicine. 2015; 72(5):330-7.
  8. Tüchsen F, Hannerz H, Burr H, Krause N. Prolonged standing at work and hospitalisation due to varicose veins: a 12 year prospective study of the Danish population. Occupational and environmental medicine. 2005;62(12):847-50.
  9. Mishra N, Solanki SL, Mishra S. Lower limb varicose veins among nurses: a cross sectional study in Udaipur. Int J Cur Res Rev. 2015; 7(24):51-5.
  10. Sharif Nia H, Chan YH, Haghdoost AA, Soleimani MA, Beheshti Z, Bahrami N. Varicose veins of the legs among nurses: occupational and demographic characteristics. International journal of nursing practice. 2015;21(3):313-20.
  11. Gozlu K, Kaya S. Patient safety culture as perceived by nurses in a Joint Commission International Accredited Hospital in Turkey and its comparison with Agency for Healthcare Research and Quality Data. Journal of Patient Safety & Quality Improvement. 2016;4(4):441-9.
  12. Alipour F, Kamaee Monfared M. Examining the relationship between job stress and organizational commitment among nurses of hospitals. Journal of Patient Safety & Quality Improvement. 2015;3(4):277-80.
  13. LALI M, ABEDI A, KAJBAF MB. Construction and validation of the lifestyle questionnaire (LSQ). PSYCHOLOGICAL RESEARCH 2012;15:0.
  14. Abelyan G, Abrahamyan L, Yenokyan G. A case-control study of risk factors of chronic venous ulceration in patients with varicose veins. Phlebology. 2018;33(1):60-7.
  15. Lee AJ, Evans CJ, Allan PL, Ruckley CV, Fowkes FGR. Lifestyle factors and the risk of varicose veins: Edinburgh Vein Study. Journal of clinical epidemiology. 2003;56(2):171-9.
  16. Yun M-J, Kim Y-K, Kang D-M, Kim J-E, Ha W-C, Jung K-y, et al. A study on prevalence and risk factors for varicose veins in nurses at a university hospital. Safety and health at work. 2018;9(1):79-83.
  17. Elamrawy S, Darwish I, Moustafa S, Elshaer N, Ahmed N. Epidemiological, life style, and occupational factors associated with lower limb varicose veins: a case control study. Journal of the Egyptian Public Health Association. 2021;96(1): 1-11.
  18. Ziegler S, Eckhardt G, Stöger R, Machula J, Rüdiger HW. High prevalence of chronic venous disease in hospital employees. Wiener Klinische Wochenschrift. 2003;115(15):575-9.
  19. Bahk JW, Kim H, Jung-Choi K, Jung M-C, Lee I. Relationship between prolonged standing and symptoms of varicose veins and nocturnal leg cramps among women and men. Ergonomics. 2012;55(2):133-9.
  20. Robertson L, Evans C, Lee A, Allan P, Ruckley C, Fowkes F. Incidence and risk factors for venous reflux in the general population: Edinburgh Vein Study. European Journal of Vascular and Endovascular Surgery. 2014;48(2):208-14.
  21. Davies AH. The seriousness of chronic venous disease: a review of real-world evidence. Advances in therapy. 2019;36(1):5-12.
  22.  Joseph N, Abhishai B, Thouseef MF, Abna A, Juneja I. A multicenter review of epidemiology and management of varicose veins for national guidance. Annals of medicine and surgery. 2016;8:21-7.
  23. Gourgou S, Dedieu F, Sancho-Garnier H. Lower limb venous insufficiency and tobacco smoking: a case-control study. American journal of epidemiology. 2002;155(11):1007-15.
  24.  Lee AJ, Evans CJ, Hau CM, Fowkes FGR. Fiber intake, constipation, and risk of varicose veins in the general population: Edinburgh Vein Study. Journal of clinical epidemiology. 2001;54(4): 423-9.